A case of eosinophilic granuloma in 38-year-old male was reported. The patient was admitted with chief complaints of pain on the left thigh, tenderness and limping associated with localized swelling on upper 1/3 of left thigh. The diagnosis was confirmed by radiological evidence and biopsy findings. This case was healed completely by curettage. The review of literature was made briefly.
Adult ; Biopsy ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Humans ; Male ; Thigh

Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.
Acute Kidney Injury ; Adult ; Cardiopulmonary Resuscitation ; Chest Pain ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Korea ; Male ; Methamphetamine* ; Outpatients ; Plasma ; Poisoning* ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Resuscitation ; Rhabdomyolysis ; Seizures ; Substance-Related Disorders

Traumatic diaphragmatic injuries (TDIs) are a rare complication in thoraco-abdominal trauma. The diagnosis is difficult and if left untreated, TDI can cause traumatic diaphragmatic hernia (TDH). Through an injured diaphragm, the liver, spleen, stomach, small intestine, and large intestine can be herniated to the thoracic cavity, but pancreatic herniation and pancreatitis are quite rare in TDH. This paper reports a case of pancreatitis developed by additional trauma in a patient with asymptomatic chronic TDH. A 58-year-old male visited the emergency department with a left abdominal injury after a fall 6 hours earlier. The vital signs were stable, but the amylase and lipase levels were elevated to 558 U/L and 1,664 U/L, respectively. Abdominal computed tomography (CT) revealed a left diaphragmatic hernia and an incarceration of the stomach, pancreatic ductal dilatation, and peripancreatic fatty infiltration. Additional history taking showed that he had suffered a fall approximately 20 years ago and had an accidentally diaphragmatic hernia through a chest CT 6 months earlier. A comparison with the previous CT revealed the pancreatitis to be caused by secondary pancreatic ductal obstruction due to the incarcerated stomach. For pancreatitis, gastrointestinal decompression was performed, and after 3 days, the pancreatic enzyme was normalized; hence, a thoracotomy was performed. A small ruptured diaphragm was found and reposition of the organs was performed. This paper reports the experience of successfully treating pancreatitis and pancreatic hernia developed after trauma without complications through a thoracotomy following gastrointestinal decompression.

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.
Angioplasty, Balloon ; Arteries ; Edema ; Humans ; Iliac Vein ; Leg ; May-Thurner Syndrome* ; Phlebography ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

No abstract available.
Eosinophils* ; Mouth Mucosa* ; Ulcer*

No abstract available.
Psoriasis* ; Infliximab

No abstract available.
Urticaria*

BACKGROUND: A variety of benign and malignant tumors can occur in the nail apparatus, causing nail deformities and growth disorders. Clinical diagnosis of nail apparatus tumors can be difficult because of their similar clinical appearance. OBJECTIVE: The aim of this study was to determine the types and frequency of nail apparatus tumors and to assess the types and frequency of nail alterations induced by tumors. METHODS: We retrospectively reviewed the medical records, clinical photos, and histologic slides of 165 patients with nail apparatus tumors who had visited Pusan National University Hospital between January 2002 and August 2012. RESULTS: The most frequently diagnosed benign tumors were digital mucous cysts (22.4%), glomus tumors (21.8%), and subungual exostoses (8.5%). The most common malignant tumors were melanomas (17.0%), squamous cell carcinomas (4.9%), and Bowen's disease (3.0%). We observed nail plate alterations in 80.6% of the cases. All cases of melanomas, fibrous tumors, and subungual exostoses produced nail alterations. Most tumors were treated with surgical management. CONCLUSION: Although the sample size of this study was small, this is the first Korean dermatologic trial to identify nail apparatus tumors. The study findings may prove useful in the clinical diagnosis of various nail apparatus tumors.
Bowen's Disease ; Busan ; Carcinoma, Squamous Cell ; Congenital Abnormalities ; Diagnosis ; Exostoses ; Glomus Tumor ; Growth Disorders ; Humans ; Medical Records ; Melanoma ; Retrospective Studies ; Sample Size

BACKGROUND/AIMS: Our previous studies of ionization and solubility of unconjugated bilirubin (UCB) yielded inappropriately large differences between the two carboxylic pK'a values of UCB. These data, however, were not ideal due to crystal effects, matastability, impurities of the bilirubin, and imprecision of analyses at low UCB. METHODS: The sodium salt of taurocholate (TC) was purified and dissolved in water to 100 mM. Chloroform (CHCl3) was purified by vacuum distillation. Buffers used were: citrate from pH 4 to 6, phosphate from pH 6 to 8, and borate above pH 8. All had an ionic strength of 0.10. The problems were minimized by rapid solvent partition of UCB from CHCl3 into buffered aqueous NaCl, and a new, accurate assay of low UCB in the aqueous phase which was achieved by concentrating the UCB through back extraction into small volumes of CHCl3. RESULTS: In contrast with the crystal dissolution studies, the two pK'a value were similar. H2B0, not HB-, was the dominant UCB species in the pH range of bile (6.0 to 8.0). The aqueous solubilities of UCB were 90 to 98% less. Less than 0.01% of the bile salt partitioned into the CHCl3 phase and self-association of B= was negligible. UCB solubilities in 50 mM TC were 2 to 10% of those obtained by crystal dissolution, and, up to pH 7.9, were below the maximum UCB concentration in normal human bile. CONCLUSIONS: We suggest that the markedly increased binding of UCB with each ionization step is due to the disruption of the internal hydrogen bonds of the ionized carboxyl groups on interaction with the bile salt. We propose to extend the study of partition to determine the activity and the degradation products of calcium salts of unbound bilirubin fractions.
Bilirubin/*chemistry ; Chloroform ; English Abstract ; Hydrogen-Ion Concentration ; In Vitro ; Solubility ; Solvents ; Taurocholic Acid/*chemistry

No abstract available.
Fibroma* ; Nipples*